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Unsuccessful stem cell remobilization for autologous transplantation is predicted by renal impairment and a stem cell yield ⩽0.5 × 106 CD34+ cells/kg at first mobilization

Bone Marrow Transplantation volume 47, pages 1372–1373 (2012)Cite this article

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PBSC mobilization for planned autologous transplantation fails in 5–40% of cases.1 Poor mobilization will result in delay or failure to proceed to transplantation and has been associated with worse survival in lymphoma patients.2 Risk factors for poor mobilization include older age, increased number and type of chemotherapies (for example, platinum compounds, alkylating agents, purine analogues and lenalidomide), prior radiotherapy, disease type, and type of mobilizing regimen1, 3 but a reproducible model is still lacking.2

Where successful remobilization is defined by a PBSC dose ⩾2–2.5 × 106 CD34+ cells/kg as the sum of first and second mobilization attempts, reported success rates are: 48% (57/119)4 and 53% (18/34)5 with G-CSF+/−chemotherapy; 60% (29/48) with recombinant human SCF+/−chemotherapy;6 73% (63/86)7 and 72% (156/217)5 with G-CSF or G-CSF+/−GM-CSF. Most recently, the CXCR4 inhibitor plerixafor combined with G-CSF has been found to successfully mobilize 70–85% of patients failing previous mobilization1 and 20/21 patients with advanced renal failure.8 Less is known about risk factors for failure at second mobilization but these are of interest if novel and potentially costly mobilization strategies are to be used selectively.

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References

  1. Mohty M, Duarte RF, Croockewit S, Hubel K, Kvalheim G, Russell N . The role of plerixafor in optimizing peripheral blood stem cell mobilization for autologous stem cell transplantation. Leukemia 2011; 25: 1–6.

    Article  CAS  Google Scholar 

  2. Pavone V, Gaudio F, Console G, Vitolo U, Iacopino P, Guarini A et al. Poor mobilization is an independent prognostic factor in patients with malignant lymphomas treated by peripheral blood stem cell transplantation. Bone Marrow Transplant 2006; 37: 719–724.

    Article  CAS  Google Scholar 

  3. Jantunen E, Kvalheim G . Mobilization strategies in hard-to-mobilize patients with lymphoid malignancies. Eur J Haematol 2010; 85: 463–471.

    Article  Google Scholar 

  4. Weaver CH, Tauer K, Zhen B, Schwartzberg LS, Hazelton B, Weaver Z et al. Second attempts at mobilization of peripheral blood stem cells in patients with initial low CD34+ cell yields. J Hematother 1998; 7: 241–249.

    Article  CAS  Google Scholar 

  5. Pusic I, Jiang SY, Landua S, Uy GL, Rettig MP, Cashen AF et al. Impact of mobilization and remobilization strategies on achieving sufficient stem cell yields for autologous transplantation. Biol Blood Marrow Transplant 2008; 14: 1045–1056.

    Article  CAS  Google Scholar 

  6. Dawson MA, Schwarer AP, Muirhead JL, Bailey MJ, Bollard GM, Spencer A . Successful mobilization of peripheral blood stem cells using recombinant human stem cell factor in heavily pretreated patients who have failed a previous attempt with a granulocyte colony-stimulating factor-based regimen. Bone Marrow Transplant 2005; 36: 389–396.

    Article  CAS  Google Scholar 

  7. Boeve S, Strupeck J, Creech S, Stiff PJ . Analysis of remobilization success in patients undergoing autologous stem cell transplants who fail an initial mobilization: risk factors, cytokine use and cost. Bone Marrow Transplant 2004; 33: 997–1003.

    Article  CAS  Google Scholar 

  8. Douglas KW, Parker AN, Hayden PJ, Rahemtulla A, D’Addio A, Lemoli RM et al. Plerixafor for PBSC mobilisation in myeloma patients with advanced renal failure: safety and efficacy data in a series of 21 patients from Europe and the USA. Bone Marrow Transplant 2012; 47: 18–23.

    Article  CAS  Google Scholar 

  9. Kroger N, Rauhoft C, Zeller W, Renges H, Hassan HT, Kruger W et al. Efficacy of further attempts to mobilize CD34+ peripheral stem cells with alternative procedures after primary failure. Acta Haematol 2000; 102: 144–147.

    Article  CAS  Google Scholar 

  10. Badros A, Barlogie B, Siegel E, Roberts J, Langmaid C, Zangari M et al. Results of autologous stem cell transplant in multiple myeloma patients with renal failure. Br J Haematol 2001; 114: 822–829.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Haematology Department, St James's Institute of Oncology, Leeds, UK

    Q A Hill & G Cook

  2. BSBMT, UCH, London, UK

    R Pearce

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  1. Q A Hill
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  2. R Pearce
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Correspondence to Q A Hill.

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Dr Cook has carried out consultancy work for Gemzyme.

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Hill, Q., Pearce, R. & Cook, G. Unsuccessful stem cell remobilization for autologous transplantation is predicted by renal impairment and a stem cell yield ⩽0.5 × 106 CD34+ cells/kg at first mobilization. Bone Marrow Transplant 47, 1372–1373 (2012). https://doi.org/10.1038/bmt.2012.20

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